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-;qU IH .. CLEANING AND STERILIZATION C Body Art Inspection Report 1. .autoclave: approved and effective - passed integrator test ❑ Date: 10/24/22 San Joaquin County Environmental Health Department El ] n 1868 E. Hazelton Ave., Stockton, CA 95205 Program Record: PRO)000= „J / (209) 468-3420 4. ntegrators used/monthly spore test/log maintained www.siogv.orp/ehd Program 5. Decontamination/sanitation area separated and supplied 3ppropriately❑ Element: 4121 =aciity Narre Address City Zip Code _ost Dreams Tattoo and Piercing 5920 Pacific Ave Stockton 95207 Vame of Pe-mit/Registration Holder Permit Exp. Date Time In Time Out Inspection Type Oichael Carer ❑ Routine The above facility is inspected for compliance with Division 104, Part 15, Chapter 7 of California Health and Safety Code (HSC) V = Violation C = Corrected On Site A/ CLEANING AND STERILIZATION C ] 1. .autoclave: approved and effective - passed integrator test ❑ ] 2' tems washed, disinfected, packaged, labeled, and sterilized El ] 3. .autoclave loaded correctly/packages allowed to dry ❑ ] 4. ntegrators used/monthly spore test/log maintained ❑ ] 5. Decontamination/sanitation area separated and supplied 3ppropriately❑ Jewelry, Inks, Needles etc approved and used correctly ❑ 6 nvoices and log kept for disposable, pre -sterilized ui ment ❑ ❑ 7. Sharps containers labeled, used, and disposed of appropriately ❑ ❑ 8 Jewelry, tattoo and piercing equipment - clean and sterilized ❑ PRACTITIONER HEALTH AND HYGIENE ❑ 9. No eating, drinking or smoking - clean clothes ❑ ❑ 10. Hands washed effectively and timely ❑ ❑ 11. Handwashing facilities properly supplied and accessible, hot water ❑ ❑ 12. Hepatitis B vaccination ❑ 13. Bloodborne Pathogen training ❑ ❑ Source: ❑ 14. Appropriate personal protective equipment available and used ❑ CUSTJMERS/CLIENTS ❑ 15. Branding is completed with no other customers in procedure area E]❑ 16. Customers eighteen (18) years of age or older El ❑ 17. Skin adequately prepared for procedure El ❑ 18. Client records approved and available - Consent form and 1 uestionraire E] ❑ 19. Appropriate aftercare instructions given to client ❑ ❑ MACHINE SAFETY AND SANITATION Wet contact time provided: ❑ 20. Safe machine design ❑ ❑ 21. Machines cleaned and disinfected between clients ❑ V MACHINE SAFETY AND SANITATION cont. C ❑ 22 Parts replaced between clients - grommets, elastic bands, ❑ etc. PREVENTING CROSS -CONTAMINATION ❑ 23. Workstation/procedure area decontaminated ❑ 24. Appropriate chemical disinfectant used ❑ ❑ Chemical used: BEST BUSINESS PRACTICES ❑ 25. Disinfectant used appropriately/sufficient contact time ❑ ❑ 32. Wet contact time provided: ❑ ❑ 26. Barriers used ❑ ❑ 27. Products applied to skin are single use/dispensed aseptically ❑ ❑ 28. Storage of inks, pigments, needles, tubes, etc. ❑ ❑ 29. Jewelry, Inks, Needles etc approved and used correctly ❑ ❑ 30. Cross -contamination avoided during all phases of procedure ❑ BEST BUSINESS PRACTICES ❑ 31. Areas separated/no living or sleeping quarters ❑ ❑ 32. Floors and walls clean and in good repair, adequate light ❑ ❑ 33. Workstation, surfaces, including chairs, armrests, etc. in repair E]ood ❑ 34. Permit/registration posted ❑ ❑ 35. Operation and employee training records present ❑ COMPLIANCE AND ENFORCEMENT ❑ 36. Plan(s) submitted for review ❑ ❑ 37. Permits obtained and available ❑ ❑ 38. Impoundment ❑ ❑ 39. Hearing scheduled ❑ ❑ 40. Closure ❑ ❑ 41. ❑ Received by (Print): Michael Carter Received by (Signature): Phone: 209-696-5757 Specialist Print): P nne Chao Specialist (Signature): Phone: 209-468-3854 Re nspection on/about: A reinspection fee of $156 per hour may be charged. Page 1 of 2 EH -11/17